Home Injury Prevention Intervention (HIPI)

Background

Between 1993 and 2002, 162,900 people were hospitalised for fall related injuries, more than 43 percent of all unintentional injury hospitalisations. More than a third of fall-related injury hospitalisations happen in the home. The home is the most common place of occurrence for fall-related injury hospitalisations among those aged 0 to 4 years.

Although most injury prevention experts would encourage the removal or remediation of environmental injury hazards in the home, there is little reliable research to link the existence of hazards in the home with injury occurrence. This lack of positive evidence has been ascribed to a combination of factors, including problems with study design, poor uptake of interventions by the groups studied and insufficient sample sizes.

The HIPI study uses a randomised controlled trial (RCT) of around 600 households in Taranaki. Our pilot study found strong associations between home injury hazards and injuries actually occurring in people’s homes, indicated that fixing fall hazards will reduce injury rates. Following the pilot, we carried out a study of home injury hazards and home injury for ACC. In the process of carrying out this study, we have developed strong community relationships, leading to excellent cooperation rates and high quality baseline injury and health data. All homes have been fully assessed for injury hazards using our standardised Healthy Housing Index.

We will also carry out a full cost-benefit appraisal of the intervention to assist translation of our research findings for decision makers.

Aim

In partnership with local community housing initiatives, this study aims to measure the health impact and benefit-costs of remediating selected home fall hazards that are common in New Zealand housing.

The specific aims are:
(1) To describe significant safety hazards in an important sub-group of NZ housing, including those occupied by people aged 65 plus;
(2) To quantify the effect on home injury risk from remediating selected home fall hazards
(3) To estimate the costs and benefits of the hazard remediations tested
(4) To assess the acceptability of home fall hazard remediations to the home occupants, including a separate analysis for MÄori
(5) To provide evidence to support investment in housing safety including estimated benefits for people aged 65 plus, MÄori, and the population in general.

Design

The design is a randomised controlled trial. The intervention involves repairing certain home fall hazards that we identified as being common and relatively easy to repair in the baseline study. Half the sample receive the repairs near the start of the study and the other half receive the repairs at the end of the study.

Participants

The participants will be occupants of Taranaki Region housing constructed before 1978 and owned by a Community Services Card holder (entitled to government assistance due to low income or pension).

Main Outcome Measures

Counts of medically treated home injuries

Counts of self-reported home injury

Potential Benefits

The potential benefits of the study include reducing the burden of injury in the home, a burden that has been growing in recent years. The participants will receive repairs that will improve their own houses and increase the value of the houses.Â Hospitals, GPs and other practitioners providing medical/dental treatment for injuries in the home will have a reduced workload.

HIPI Supporters

The study is funded by the Health Research Council. The Taranaki Home Injury Hazards study was funded by ACC.
For more information, contact Project Manager, Dr Michael Keall.